羟基磷灰石涂层基牙种植体的研究进展

本文介绍了牙种植体羟基磷灰石涂层的制备技术，对涂层的结构组成、存在问题和羟基磷灰石涂层牙种植体植入后的骨组织反应特点进行了综述。     

钛芯羟基磷灰石涂层种植体即刻种植的临床观察

目的：观察钛芯羟基磷灰石涂层二段式种植体即刻种植的临床效果。方法：16例患者在拔牙同时植入钛芯羟基磷灰石涂层二段式种植体20枚,种植体上部和牙槽骨间的间隙植入致密多晶羟基磷灰石颗粒人工骨,唇颊侧粘骨膜瓣复位同腭侧牙龈相对缝合,封闭种植窝。3－6个月后进行上部义齿的修复。结果：经3－8年观察,15例19个种植体成功,1例因种植体周围炎拔除。结论：只要选择适当的病例,严格遵循种植外科的操作原则和技术,即刻种植是可行的并能达到和延期种植相似的效果。     

羟基磷灰石涂层骨内牙种植体的研究进展

本文介绍了牙种植体羟基磷灰石涂层的制备技术,对涂层的结构组成、存在问题和羟基磷灰石涂层牙种植体植入后的骨组织反应特点进行了综述。     

羟基磷灰石涂层钛种植体远期临床疗效评价

目的 观察BAM羟基磷灰石涂层钛人工种植牙的远期疗效。方法 18例牙齿缺失的患者，共植入BAM种植体23颗，术后每年定期观察，进行疗效评定。结果 经5～9年随访，成功9颗，失败14颗，成功率39．13％。结论 BAM种植体远期效果欠佳，其涂层工艺及结构有待改进。     

骨内牙种植体六年临床观察

目的：评价牙种植体的临床效果。方法：对192例281枚种植体进行了6年的临床观察,采用的种植体为叶状、螺旋状和羟基磷灰石涂层（Ti-HAc）种植体。结果：牙种植体6年临床观察的成功率为89.68%,种植体周围炎和机械性折断是种植体失败的主要原因。     

羟基磷灰石涂层种植体失败的主要原因及其处理方法

羟基磷灰石是目前公认的具有良好生物相容性和骨传导性的生物活性材料。羟基磷灰石涂层种植体已广泛应用于临床，并取得了良好效果，本将羧基磷灰作层种植体与纯钛种植体进行了比较。指出由于羟基磷灰石自身的缺陷及喷涂过程对羟基磷灰石特性的影响，均会导致种植后的细菌感染，He创伤，涂层溶解，涂层剥脱等，改进的措施包括彻底清理病变部位，制作生长因子／羟基磷灰石复合涂层及改进喷涂工艺等。     

氮化硅复合种植体-骨界面的剪切强度

目的：测试并分析新型种植体及钛种植体与骨的剪切强度。方法：以Ｂｅａｇｌｅ犬为实验对象,羟基磷灰石（ＨＡ）涂层钛种植体及钛合金种植体为对照,用力学测试方法研究新型种植体－氮化硅复合羟基磷灰石涂层种植体和单一氮化硅种植体植入股骨后,不同时期种植体－骨界面的剪切强度。结果：两种有涂层的种植体植入后１个月,其界面剪切强度高于非涂层者,但３个月后实验组的两种种植体界面剪切强度明显高于对照组,与骨形成更牢固的     

柱状二段式HA—Ti牙种植体根桩的外科植入及其临床应用

本文报告了２８例共５５颗外科二期完成的柱状二段式钛芯羟基磷灰石涂层牙种植体修复单个或全口牙缺失的近期临床效果，经１８个月的随访观察，无一例牙种植体发生松动，脱落，本文还就其适应症，牙种植体外科植入手术操作，及其成功的评价标准进行了讨论。     

XIVE种植体同期植入珊瑚羟基磷灰石的临床应用

目的：观察应用XIVE种植体行口腔种植治疗并同期植入珊瑚羟基磷灰石（CHA）的临床效果。方法：12例患者在使用XIVE种植系统进行口腔种植修复时,应用成品珊瑚羟基磷灰石作为同期骨增量治疗的植入材料。结果：术后随访全部病例均无全身性异常反应,术后创口愈合良好,无异物排出现象,种植体稳定度好。X线片显示植入3月后珊瑚骨密度逐渐降低,而珊瑚骨之间的空隙密度增高,6～9个月珊瑚羟基磷灰石基本完全吸收。结论：珊瑚羟基磷灰石具有良好的生物相容性和骨诱导性,在应用XIVE种植体时可作为同期植入的骨增量植入材料。     

表面氧化处理钛种植体—骨界面动物实验观察

为了确定氧化钛种植体的愈合过程 ,作者将氧化钛种植体作为研究对象 ,羟基磷灰石涂层种植体作为对照 ,将种植体植入成犬股骨中 ,在术后 1月、2月、3月、4月处死动物 ,通过扫描电镜观察标本 .结果发现 :在种植后 1月 ,HA涂层的种植体与骨组织已有较好的初期愈合 ,氧化钛材料的初期骨组织愈合不如 HA涂层的种植体 ,在4个月的标本中 ,氧化钛涂层的种植体与 HA涂层的种植体无明显差异 ,均达到良好的骨性结合 .     

生物活性玻璃—钛芯人工牙根临床应用成败探讨

作者报道了生物活性玻璃－钛芯人工牙奶的临床应用，对２４６例缺牙患者共种植２５２只牙根，成功２２８只，成功率为９０．４７％，失败２４只，占９．５３％。文中就种植成败的原因进行了详细探讨，对种植体周围炎及有关并发症的预防方法，结合临床资料进行重点讨论。     

Single tooth crowns supported on hydroxyapatite coated endosseous dental implants: a prospective 5-year study on twenty subjects

AIM: To evaluate the success and maintenance requirements of cylindrical, hydroxyapatite coated implants used as single-tooth implants. DESIGN: A five-year prospective trial. METHOD: Twenty patients, attending the Department of Prosthetic Dentistry at GKT Dental Institute, London, were provided with 23 Calcitek, Integral Omniloc single tooth implants. Annual reviews were undertaken for five years. Assessment criteria included implant survival; abutment or crown looseness; radiographic evidence of bone loss; evidence of plaque and inflammation of the mucosal cuff; the patient's perception of the restoration. RESULTS: All implants integrated. Two subjects, with three crowns, dropped out giving a known cumulative survival rate of 87%. Twelve implants exhibited no measurable bone loss and six demonstrated funnel formation up to 2mm in depth which, at five years, appeared to be stable; three implants exhibited continuing bone loss and their inclusion as failures gives a known success rate of 74%. The abutments came loose on four occasions; the crowns decemented on 12 occasions; two crowns were repaired and one remade. The appearance was judged to be good or very good. CONCLUSION: The prospective study indicated that hydroxyapatite coated implants can be successful as single tooth implants, over a five-year period.     

A prospective multicenter clinical study of the Osseotite implant: four-year interim report

This article reports the 4-year interim results of a multicenter study evaluating the clinical performance of the Osseotite dental implant. At 4 study centers, 485 Osseotite implants were consecutively placed in 181 patients (219 were placed in the mandible and 266 in the maxilla). A total of 355 implants were placed in posterior regions. Short implants (10 mm or less) represented 31.5% (n = 153) of all implants placed in this study. Patients were restored with 210 restorations, distributed as 123 short-span prostheses, 58 single-tooth replacements, 28 long-span prostheses, and 1 maxillary overdenture. At this 4-year interim evaluation, the mean time from implant placement to the most recent evaluation was 52.6 +/- 3.0 months, with a mean loading time of 43.3 +/- 3.8 months. Of the 485 implants placed, there have been 6 failures. All implant failures occurred prior to loading and were categorized as early implant failures. Five of the 6 failures occurred in the maxilla. Only one of the 153 short implants failed to integrate. Baseline radiographs were obtained at prosthesis connection. Radiographic analysis 1 year post-restoration showed a mean bone loss of 0.09 +/- 0.7 mm. From baseline to the end of the second year of function, an overall mean bone loss of 0.13 +/- 0.8 mm was recorded, indicating no additional bone was lost after the first year of implant function. At 4 years, the cumulative implant success rate for all implants placed in this study was 98.7%, with a 99.4% success rate in the posterior mandible and 98.4% success rate in the posterior maxilla. Results of this 4-year interim analysis indicate that this implant achieved a high success rate in posterior regions and that all failures with this implant in this patient population occurred prior to implant loading. When the clinical success of implants 10 mm or shorter was compared to that of implants greater than 10 mm in length, the shorter implants in this study performed similarly to longer implants.     

Cylindrical dental implants with hydroxyapatite- and titanium plasma spray-coated surfaces: 5-year results

Clinical follow-up was conducted on 127 cylindrical implants placed in 21 patients after 5 years of function: 75 implants were coated with titanium plasma spray (TPS) and 52 implants were coated with hydroxyapatite (HA). The aim of the study was to assess possible differences in clinical function and success rates for each implant type. Clinical and radiographic evaluations were conducted, and the periodontal indices of gingival bleeding, plaque, and calculus were measured. Cumulative data were analyzed for differences by implant type and jaw location. No significant differences were found between the 2 implant systems according to the periodontal parameters studied; however, 5-year success rates were 86.7% for TPS-coated implants and 94.3% for HA-coated implants. The periodontal probe index presented abnormal values in the patients with systemic disease and those who were provisionally restored with single-tooth restorations, complete screw-retained dentures, and fixed partial dentures. There were no differences regarding implant placement when mandibles and maxillae were compared. Long-term success rates were outstanding for HA-coated implants and acceptable for TPS-coated implants after 5 years of function. No significant differences were found between the 2 surfaces.     

Ultrastructure of the interface between titanium and surrounding tissue in rat tibiae--a comparison study on titanium-coated and -uncoated plastic implants

Purposes The purposes of this study were to prepare experimental titanium‐coated plastic implants suitable for electron microscopy examination of the titanium‐bone interface and the response of tissue surrounding titanium, and to histologically compare surrounding tissue responses in coated and uncoated implants. Materials and Methods Experimental plastic implants were prepared from a plastic rod coated with a thin film of titanium. Plastic implants without coatings were used as controls. The implants were placed into tibiae of 10‐week‐old male rats. The specimens with implants were harvested 4 weeks after placement and observed under a light microscope, a transmission electron microscope, and a scanning electron microscope. Results In the transmission electron microscopy, the titanium layer of the experimental implant was a uniform layer that was approximately 150‐ to 250‐nm wide. The new bone formation was observed around both titanium‐coated implants and plastic implants. However, there was no direct bone contact with the plastic implant. Discussion The responses of tissue surrounding the experimental implants varied. Under an electron microscope, the following areas were observed: (1) an area with a direct contact between the titanium and bone, (2) an area at the interface where an amorphous layer was observed, (3) an area with progressing calcification in the surrounding tissue where the cells were adjacent to the titanium surface, and (4) an area in which bone resorption and apposition were observed and remodeling was thought to be occurring. Conclusion The experimental titanium was homogenous and was considered to be highly useful in observing the responses of the surrounding tissue to the titanium surface.     

短种植体在骨高度不足后牙区种植修复的临床短期观察

目的：观察、分析BICON短种植体在后牙区骨高度不足病例种植修复的临床效果。方法：上、下颌后牙区骨高度3-9mm的病例57例,共植入BICON短种植体101枚,长度5.7mm的种植体15枚,长度6mm的种植体20枚,长度8mm的种植体66枚。下颌共植入59枚种植体,上颌共植入42枚种植体,其中上颌窦窦底牙槽骨高度不足的患者行上颌窦底冲击术同期植入种植体和人工植骨材料（天博骨粉）。3-6个月行二期手术,二期术后3-4周完成基台一体化冠永久修复。结果：55例99枚BICON短种植体均获得了良好的骨结合,经12个月的临床观察,种植修复取得了较好的临床效果,X光片及牙科CT检查,种植体颈部骨组织及种植体周围骨组织稳定.上颌2例2枚种植体二期手术时松动脱落,种植成功率98.02%。结论：在后牙区骨高度不足的病例,通过植入BICON短种植体,不仅可以简化植骨术,缩短患者的治疗时间,并且能减少手术风险,使种植体能获得较理想的种植成功率。     

A retrospective analysis of sandblasted, acid-etched implants with reduced healing times with an observation period of up to 5 years

PURPOSE: The aim of this study was to evaluate the success rate of 2 different implant systems with sandblasted and acid-etched modified surfaces loaded after reduced healing periods. MATERIALS AND METHODS: One-hundred seventeen patients with a mean observation period of 3.75 years (24 to 61 months) were included in this evaluation. Chart reviews of a standardized recall program were evaluated. All 532 placed implants showed an unloaded healing time of 6 weeks in the mandible and 12 weeks in the maxilla. At abutment placement a torque value of 35 Ncm was one of the primary variables, and the success of the implants over time was determined by the criteria of Buser et al. The survival was analyzed using Kaplan-Meier method, and the probability of an event within 1 group independent of time was evaluated using the chi-square test and Fisher exact test. RESULTS: Of the 532 implants, 235 were placed in female and 297 in male patients; 448 implants were located in the maxilla and 84 in the mandible. Three implants were lost prior to abutment connection in 3 patients. Life table analyses show an overall success rate of 99.4% at 5 years, as no implants were lost after abutment connection. There was no significant association of the implant type (P = .185), gender (P = .99), or jaw (maxilla/mandible; P = .06) and the survival of the implants within this study. CONCLUSION: Based on the data found in this investigation, it can be concluded that implants with sandblasted, acid-etched surfaces can be restored after a 6- to 12-week healing period with a high predictability of success.     

Ankylos种植体用于前牙美学区3~5年的临床效果分析

目的:回顾性研究Ankylos种植体用于前牙美学区的临床效果,以探讨其应用价值。方法:烟台市口腔医院种植中心自2008年4月~2010年4月共200位患者植入Ankylos种植体325枚。因电话及地址变更,选取参与复诊的175位患者共213枚种植体,术后随访3~5年,观察种植体成功率、留存率、边缘骨吸收情况以及龈乳头充填指数等指标。结果:175位患者共植入213颗Ankylos种植体,观察时间为36~60个月,平均观察时间46.7个月,种植体成功率为93%,种植体留存率为94.8%,未植骨组边缘骨变化为(0.98±0.45) mm,植骨组边缘骨变化为(1.45±0.26) mm,两组差异具有统计学意义(P＜0.05);植骨组中Bio-oss骨粉+自体骨屑组边缘骨吸收为(0.65±0.46) mm,单独植骨组边缘骨吸收为(1.02±0.39) mm,两组差异具有统计学意义(P＜0.05)。结论:Ankylos种植体用于前牙美学区临床效果满意,种植体成功率和留存率高,边缘骨吸收较少,美学效果理想。但因本研究因限样本量和观察时间等条件限制,其相关临床研究有待进一步验证。     

A retrospective study of dental implants in diabetic patients

The efficacious placement of dental implants in diabetic patients remains controversial. Definitive guidelines with objective criteria, including the type of diabetes, age of onset, and level of long-term control, have not been determined. In addition, few relevant literature citations assess the survival rate of implants in diabetic patients. Therefore, it is the purpose of this study to assess the success and survival rates of dental implants in diabetic patients. In this retrospective analysis, 215 implants placed in 40 patients at 2 clinical centers were evaluated. Chart reviews and interviews provided medical and implant data. From the analysis, 31 failures occurred, for an overall success rate of 85.6%. Of these failures, 24 occurred within the first year of functional loading. The mean time of functional load was 4.05 +/- 2.6 years. When the success rate was analyzed by implant location, success rates for the maxilla and mandible were 85.5% and 85.7%, respectively. For the anterior and posterior regions, success rates were 83.5% and 85.6%, respectively. The lifetable analysis revealed a cumulative success rate of 85.7% after 6.5 years of function. Based on the data, the survival rate of dental implants in controlled diabetic patients is lower than that documented for the general population, but there is still a reasonable success rate. The increase in failure rate occurs during the first year following prosthetic loading.